Y9E-24867-08271
4 vaccinations
7 coded responses
56 check-ins
7 free-text entries
1 call case
- Sex
- Male
- Age at first dose
- 66+
- ZIP prefix
- 724 / AR
- Registered
- 2021-03-05
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-05
Registered in v-safe
-
2021-03-05
Dose 1 — Moderna
- 2021-03-05
- 2021-03-06
- 2021-03-07
- 2021-03-08
- 2021-03-09
- 2021-03-10
- 2021-03-11
- 2021-03-12
-
2021-03-19
Survey response — day 14, dose 1MedDRA: Cough, Nasal congestion, Oropharyngeal pain, Pyrexia — Feeling: Good · Be unable to do your normal daily activitiesFree text: Sore throat, lots of nasal congestion, some coughing, low grade feverMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-26
-
2021-04-02
Dose 2 — Moderna
- 2021-04-02
- 2021-04-03
- 2021-04-04
- 2021-04-05
- 2021-04-06
- 2021-04-07
- 2021-04-08
- 2021-04-09
- 2021-04-16
- 2021-04-23
- 2021-04-30
- 2021-05-07
- 2021-05-14
- 2021-07-02
- 2021-10-01
-
2021-10-29
Dose 3 — Moderna
- 2021-10-29
- 2021-10-30
- 2021-10-31
- 2021-11-01
- 2021-11-02
-
2021-11-03
Survey response — days 1–6 daily, dose 3MedDRA: Headache — Feeling: GoodFree text: Have a headache but don't believe it is in anyway related to my vaccinationMedDRA releases: 2024-11 · check-in free text available
- 2021-11-04
- 2021-11-05
- 2021-11-12
- 2021-11-19
-
2021-11-26
Survey response — day 28, dose 3MedDRA: Gastrointestinal disorder, Muscle strain — Feeling: FairFree text: I have had some stomach issues and strained shoulderMedDRA releases: 2024-11 · check-in free text available
- 2021-12-03
- 2021-12-10
-
2022-01-28
Survey response — 3 months, dose 3MedDRA: Cough, Nasal congestion, Nasopharyngitis, Rhinorrhoea, Secretion discharge — Feeling: GoodFree text: I had a cold, coughing up some mucus and runny stuff nose. No fever that I was aware of.MedDRA releases: 2024-11 · check-in free text available
- 2022-04-29
-
2022-06-10
Dose 4 — Moderna
-
2022-06-10
Survey response — day 0, dose 4MedDRA: No adverse event — Feeling: GoodFree text: NoMedDRA releases: 2024-11 · check-in free text available
- 2022-06-11
- 2022-06-12
- 2022-06-13
- 2022-06-14
- 2022-06-15
- 2022-06-16
- 2022-06-17
- 2022-06-24
- 2022-07-01
- 2022-07-08
- 2022-07-15
-
2022-07-22
Survey response — day 42, dose 4MedDRA: Ageusia, Cough, Throat irritation — Feeling: GoodFree text: Throat tickle, cough, loss of tasteMedDRA releases: 2024-11 · check-in free text available
- 2022-09-09
-
2022-12-09
Survey response — 6 months, dose 4MedDRA: Heart rate decreased, Ventricular extrasystoles — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Having some pvc's and some slow heart rate problems. Hope to get them worked out!MedDRA releases: 2024-11 · check-in free text available
-
2022-12-09
Report sent to call center — 6 months, dose 4Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-12-13
-
2022-12-15
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
- 2023-06-10
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-05 | Moderna | |
| 2 | 2021-04-02 | Moderna | |
| 3 | 2021-10-29 | Moderna | No |
| 4 | 2022-06-10 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-12-09 | Successful 2022-12-15 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
Free text
Release 5 — day 14, dose 1
Symptoms: Sore throat, lots of nasal congestion, some coughing, low grade fever
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Have a headache but don't believe it is in anyway related to my vaccination
Release 10 — day 28, dose 3
Symptoms: I have had some stomach issues and strained shoulder
Release 11 — 3 months, dose 3
Symptoms: I had a cold, coughing up some mucus and runny stuff nose. No fever that I was aware of.
Release 12 — day 0, dose 4
Systemic reaction (other): No
Release 12 — day 42, dose 4
Symptoms: Throat tickle, cough, loss of taste
Release 12 — 6 months, dose 4
Symptoms: Having some pvc's and some slow heart rate problems. Hope to get them worked out!
Each entry is dated by the survey it was written in (the CDC re-sent the releases with survey dates in 2025); click a date to see that survey response. The CDC cut some text off at about 250 characters: symptoms in every release, and the other two fields in releases 9-12. Those entries are marked "cut off by CDC".
MedDRA terms by release
| Field | Preferred term | 2021-09 | 2023-04 | 2024-11 |
|---|---|---|---|---|
| SD | Ageusia | · | · | ✓ |
| SD | Cough | ✓ | ✓ | ✓ |
| SD | Gastrointestinal disorder | · | · | ✓ |
| SD | Heart rate decreased | · | · | ✓ |
| SD | Muscle strain | · | · | ✓ |
| SD | Nasal congestion | ✓ | ✓ | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Oropharyngeal pain | ✓ | ✓ | ✓ |
| SD | Pyrexia | ✓ | ✓ | ✓ |
| SD | Rhinorrhoea | · | · | ✓ |
| SD | Secretion discharge | · | · | ✓ |
| SD | Throat irritation | · | · | ✓ |
| SD | Ventricular extrasystoles | · | · | ✓ |
| SRO | Headache | · | · | ✓ |
| SRO | No adverse event | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release